Metabolism of free fatty acids in patients with gastrointestinal diseases depending on the body mass index
Authors: Yu.M. Stepanov, L.M. Mosiychuk, I.A. Klenina, V.A. Karachynova, O.M. Shevtsova, O.P. Petishko
Journal: GASTROENTEROLOGY (2023)

Background. The purpose of the study is to analyze the content of free fatty acids (FFA) in the blood serum of overweight and underweight patients with gastrointestinal diseases. Mate­rials and methods. Thirty-one patients with gastrointestinal diseases were examined, 19 (61.3 %) men and 12 (38.7 %) women with a median age of 39 (27; 48) years. Depending on the results of the body composition study with the multifunctional monitor TANITA MC-780MA (Japan), they were divided into the following groups: overweight patients (body mass index (BMI) more than 25.0 kg/m2) and underweight persons (BMI below 18.5 kg/m2). Determination of the FFA spectrum in the blood serum was carried out using a gas chromatograph with a flame ionization detector Chromatek-Crystal 5000. The control group consisted of 16 practically healthy people. Statistical processing of the results was carried out using the Statistica 6.1 application program package. Results. Patients with a change in body weight reported a statistically significant decrease in the median total content of short-chain saturated FFA (C4:0) mainly due to a decrease in the butyric acid content by 67 times (p = 0.001) with increased BMI and by 114 times (p = 0.002) with decreased BMI compared to controls. At the same time, the analysis of the serum spectrum of saturated FFA with an average carbon chain length showed a probable increase in the content of capric acid by 14 times (p &lt; 0.01), undecyl acid by 19 times (p &lt; 0.01), and lauric acid by 25 times (p &lt; 0.001) in patients with changes in body weight. The content of caproic acid increased in the group with excessive body weight by 3.9 times (p = 0.046) compared to controls and by 2.6 times (p &gt; 0.05) compared to underweight patients. The total content of monounsaturated FFA in the blood serum of patients with increased and decreased BMI increased significantly by 32 times (p &lt; 0.001) and 19 times (p = 0.001), respectively, compared to controls. The total content of polyunsaturated FFA in the blood serum of patients of both groups was found in a trace amount. Overweight patients had a 38-fold (p &lt; 0.01) increase in the trans-FFA elaidic acid (C18:1(trans-9)) compared to controls, while underweight patients had a decrease in linoelaidic acid (C18:2(trans-9,12)) by 11.7 times (p &lt; 0.05). Correlation analysis revealed a positive relationship between BMI and increased serum content of saturated caproic acid (r = 0.39; p = 0.019); monounsaturated acids — palmitoleic (r = 0.33; р = 0.045) and heptadecenoic (r = 0.35; р = 0.034); trans-configuration fatty acids — elaidic (r = 0.43; p = 0.009) and linoelaidic (r = 0.43; p = 0.007). Conclusions. Patients with gastrointestinal diseases had an imbalance in the fatty acid spectrum of the blood serum. Against the background of the tendency to decrease the total content of short-chain saturated FFA, a significant increase in the content of monounsaturated FFA and trans-FFA was noted, especially with increased BMI. In all patients, the trace amount of polyunsaturated FFA fractions was found. The obtained results can be used to improve the differential treatment of metabolic disorders in patients with gastrointestinal tract pathology.